Endodontology
The induction of cytotoxicity, oxidative stress, and genotoxicity by root canal sealers in mammalian cells

https://doi.org/10.1016/j.tripleo.2009.07.015Get rights and content

Objective

Toxicologic aspects of the root canal sealers Acroseal, Epiphany, AH Plus, and castor oil polymer (COP) were analyzed using cell culture techniques.

Study design

Set materials were extracted in culture medium, and cytotoxicity and the generation of reactive oxygen species (ROS) were determined in human pulp cells. The formation of micronuclei (MN), indicative of genotoxicity and changes of the cell cycle, were analyzed in V79 cells.

Results

The ranking of the most to the least toxic material was: Acroseal > Epiphany = AH Plus ≫ COP. The production of ROS was increased by Epiphany, Acroseal, and AH Plus about 4-7-fold, but enhanced ROS production was not detected with COP. Acroseal, Epiphany, and AH Plus increased the numbers of MN, and Acroseal delayed the cell cycle in G2 phase.

Conclusion

The materials which tested cytotoxic in the present study may be able to alter oral tissue–specific functions and cause inflammation.

Section snippets

Preparation of extracts

Four materials were included in this study: AH Plus (Dentsply Maillefer, Konstanz, Germany); Epiphany (Pentron Clinical, Wallingford, CT); Acroseal (Septodont, Saint-Maur-des-Fossés, France); and COP (Polifil; Poliquil Araraquara Polímeros Químicos, Araraquara, Brazil). Polifil is a material which consists of a liquid (polymer extracted from oil of Ricinus communis), a paste (polyester), and zinc oxide as described recently.5 Specifications of the endodontic sealers tested are listed in Table I.

Cytotoxicity of endodontic sealers

All sealers tested cytotoxic under the experimental conditions except for COP, but the extent of effects varied between the materials, as indicated by the differences in the dose-response relationship (Fig. 1). Acroseal was found to be the most cytotoxic material, because a 1:4 dilution of its original extracts reduced cell numbers to 5% compared with untreated negative control cultures. The slight increase in optical density readings detected in cell cultures exposed to higher-concentrated

Discussion

The scientific value of the in vitro evaluation is beyond doubt according to our current understanding of the preclinical testing of the biocompatibility of dental materials. The aim of the use of in vitro cell culture techniques is to study toxicity but not tissue response. Tissue reaction is a result of several factors, among which toxicity is only one. Yet, one can predict that a considerably toxic material will cause severe irritation to tissues in vivo.25 It has also been suggested that

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    Supported by the Department of Operative Dentistry and Periodontology, University of Regensburg, Germany, and the State of São Paulo Research Foundation (FAPESP), São Paulo, Brazil—process no. 07.1744-2.

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